Comparison of clinicopathological features between uVIN and dVIN
| uVIN | dVIN | |
|---|---|---|
| Prevalence | More common | Less common |
| Age | Young women (40–49 years) | Postmenopausal women (66–69 years) |
| Distribution | Multifocal | Usually unifocal |
| Risk factors | HPV infection, immunosuppression | Chronic skin inflammatory conditions (LS, lichen simplex chronicus, squamous cell hyperplasia) |
| Morphology | ▸ Nuclear atypia (high nuclear/cytoplasmic ratios, nuclear enlargement, hyperchromasia) ▸ Decreased cellular maturation ▸ Increased mitotic activity above basal layer | ▸ Basal cell nuclear atypia ▸ Atypical mitosis in basal layer ▸ High maturation of superficial squamous cells ▸ Dyskeratosis, prominent nucleoli, elongation and anastomosis of rete ridges ▸ Prominent intercellular bridges |
| Type of SCC | Basaloid/warty SCC | Keratinizing SCC |
| Frequency of progression to invasive cancer | 5.7% | 33% |
| Immunohistochemistry | p16+ (diffuse, band-like), p53− | p53+(85%), p16− or focally + |
dVIN, differentiated or simplex-type vulvar intraepithelial neoplasia; HPV, human papilloma virus; LS, lichen sclerosus; SCC, squamous cell carcinoma; uVIN, usual vulvar intraepithelial neoplasia.